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VIEWPOINT | The ‘big beautiful bill’ is an ugly deal for South Dakotans

Guest column by Dr. Shannon Emry, a pediatrician/clinical professor at USD Sanford School of Medicine

Jun 29, 2025
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Shannon Emry

The U.S. Senate has released its version of the “big beautiful bill” – a massive tax package that gives money directly to the wealthiest Americans while gutting programs that help everyday South Dakotans. If passed, this bill would cause devastating harm through deep cuts to Medicaid, higher healthcare costs for those enrolled in the Affordable Care Act and automatic cuts to Medicare.

This bill will increase the federal deficit, resulting in the Statutory Pay-As-You-Go Act (PAYGO) kicking in. That law requires automatic, across-the-board cuts to programs like Medicare unless Congress intervenes. So not only does this bill extend $1.1 trillion in tax breaks to the wealthiest Americans, it pulls the rug out from under those who rely on Medicare just to get by.

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